單側雙通道脊柱內鏡下后方減壓聯合頸椎前路椎間盤切除融合術治療多節段混合型頸椎病二例_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

付豪 ^1,2 , 胡宇童 ^1,2 , 楊東方 ² ,  許衛兵 ²

1. ;
2. ;

Corresponding?author：

許衛兵, Email: xuweibingsmmu@163.com

Keywords：

單側雙通道脊柱內鏡技術; 多節段混合型頸椎病; 頸椎前路椎間盤切除融合術; 頸椎后路椎間孔切開減壓術; 聯合手術

DOI：

10.7507/1002-1892.202205137

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目的總結單側雙通道脊柱內鏡下頸椎后路椎間孔切開減壓術（unilateral biportal endoscopic posterior cervical foraminotomy，UBE-PCF）聯合頸椎前路椎間盤切除融合術（anterior cervical discectomy and fusion，ACDF）治療2例多節段混合型頸椎病的經驗。方法 2022年2月及3月收治2例多節段脊髓型頸椎病、神經根型頸椎病及退行性頸椎滑脫患者。男、女各1例；年齡分別為59、66歲。患者上肢感覺減退、Hoffmann征陽性，影像學檢查示頸椎不穩、椎間盤突出以及左側椎間孔狹窄。全身麻醉下對相應病變節段行ACDF以及UBE-PCF。結果 2例手術時間分別為186、145 min，術后切口Ⅰ期愈合。患者均獲隨訪3個月。術后2 d及3個月疼痛視覺模擬評分（VAS）、頸椎功能障礙指數（NDI）均較術前下降，日本骨科協會（JOA）評分較術前上升。影像學復查示治療節段神經減壓徹底，未出現頸椎不穩。結論對于伴退行性頸椎滑脫的多節段混合型頸椎病，ACDF聯合UBE-PCF能選擇性處理不同節段病變，最大程度保留脊柱功能，獲得良好近期療效。

Citation： 付豪, 胡宇童, 楊東方, 許衛兵. 單側雙通道脊柱內鏡下后方減壓聯合頸椎前路椎間盤切除融合術治療多節段混合型頸椎病二例. Chinese Journal of Reparative and Reconstructive Surgery, 2022, 36(10): 1241-1243. doi: 10.7507/1002-1892.202205137 Copy

1.	Luo CA, Lim AS, Lu ML, et al. The surgical outcome of multilevel anterior cervical discectomy and fusion in myelopathic elderly and younger patients. Sci Rep, 2022, 12(1): 4495. doi: 10.1038/s41598-022-08243-8.
2.	Gatam AR, Gatam L, Phedy, et al. Full endoscopic posterior cervical foraminotomy in management of foraminal disc herniation and foraminal stenosis. Orthop Res Rev, 2022, 14: 1-7.
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1. Luo CA, Lim AS, Lu ML, et al. The surgical outcome of multilevel anterior cervical discectomy and fusion in myelopathic elderly and younger patients. Sci Rep, 2022, 12(1): 4495. doi: 10.1038/s41598-022-08243-8.
2. Gatam AR, Gatam L, Phedy, et al. Full endoscopic posterior cervical foraminotomy in management of foraminal disc herniation and foraminal stenosis. Orthop Res Rev, 2022, 14: 1-7.
3. Nouri A, Tetreault L, Singh A, et al. Degenerative cervical myelopathy: epidemiology, genetics, and pathogenesis. Spine (Phila Pa 1976), 2015, 40(12): E675-E693.
4. Ninomiya K, Yamane J, Aoyama R, et al. Clinical effects of anterior cervical spondylolisthesis on cervical spondylotic myelopathy after posterior decompression surgery: A retrospective multicenter study of 732 cases. Global Spine J, 2022, 12(5): 820-828.
5. Yuan H, Zhang X, Zhang LM, et al. Comparative study of curative effect of spinal endoscopic surgery and anterior cervical decompression for cervical spondylotic myelopathy. J Spine Surg, 2020, 6(Suppl 1): S186-S196.

Chinese Journal of Reparative and Reconstructive Surgery

單側雙通道脊柱內鏡下后方減壓聯合頸椎前路椎間盤切除融合術治療多節段混合型頸椎病二例

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